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Certification: <br /> As an authorized representative of the applicant, I hereby certify that the operation <br /> described has met the minimum requirements of the following terms and conditions: <br /> 1. All necessary approvals from local government have been applied for <br /> (Section 34-32.5-110 (1) (a) (viii) . <br /> 2. To the best of my knowledge, all significant, valuable and permanent man-made <br /> scructure(s) in existence at the time this application is filed, and located within 200 <br /> feet of the proposed affected area have been identified in this application (Section 34- <br /> 32.5-115 (4) (e) , C.R.S. ) . (NOTE: For 110 operations, the affected area includes all lands <br /> delineated by the permit boundary. ) <br /> 3 . No mining operation will be located on lands where such operations are prohibited by <br /> law (Section 34-32.5-115 (4) (f) , C.R.S. ) . <br /> 4. As the applicant/operator, I do not have any mining/prospecting operations in the <br /> State of Colorado currently in violation of the provisions of the Colorado Land <br /> Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, <br /> C.R.S. ) . <br /> 5. I understand that statements in the application are being made under penalty of <br /> perjury and that false statements made herein are punishable as a Class 1 misdemeanor <br /> pursuant to Section 18-8-503, C.R.S 1984. <br /> Signed and dated this z 1Y �4 day of M are h 11• <br /> Rio Blanco County Road and Bridge <br /> Jerry Steele If Corporation Attest (Seal) <br /> Applicant/operator <br /> Signed: Signed: n <br /> Cor orate Secretary or. Equivalent <br /> Title: $upprvisor Town/City/County �;,]gr$ <br /> State of Colorado ) <br /> ss <br /> County of Rio Blanco ) <br /> The foregoing instrument was acknowledged before me this � day of 7 Y1<GLr.�I /999, <br /> Rio Blanco County Road <br /> by -Jerry Steele as c„peruianr of and bridge Department. <br /> Notary Public <br /> My Commission expires: <br /> SIGNATURES MUST BE IN BLUE IM <br /> 04/2=.197 2921FCO._10 <br />